THE 1918–1919 FLU PANDEMIC

IT’S FLU season. Wife Dottie and I have got our shots. I recommend the same to SimanaitisSays readers, even those who may be shot-challenged for whatever reason. By way of stressing the importance of flu prevention, I share here the history of an unusually deadly influenza pandemic, the 1918-1919 world flu aka the Spanish Flu.

Some definitions first: Influenzas are viral infections with a wide range of types, symptoms, and complications. Typical symptoms are high fever, runny nose, sore throat, muscle pains, headache, coughing and feeling really blah.
Most flus show up two days after exposure and last less than a week. At their worst, flu infections can lead to viral pneumonia, secondary bacterial infections, and worsening of previous health problems such as asthma or heart trouble.

Don’t confuse flu with gastroenteritis, an unrelated stomach infection of more widely varied causes and often incorrectly called the stomach flu.

Even simple viral flu isn’t simple.

Calling a flu “pandemic” implies its worldwide scale. There are roughly three flu pandemics per century; our most recent one being the 2009 pandemic known as swine flu. Both it and the 1918-1919 pandemic involved the H1N1 virus specifically affecting birds, swine, and humans.

Back in 1918-1919, the H1N1 virus infected 500 million people around the world. Between 50 and 100 million of these died—three to five percent of the world’s population, making this one of the deadliest natural disasters in human history.

Mortality data of three successive waves of flu in Britain, June 1918 through May 1919.

H1N1 differs from other flu viruses in being fatal to young adults, not, like other flus, most vulnerable to infants, the elderly, or those with compromised immune systems. In the 1918-1919 onslaught, 99 percent of U.S. flu deaths occurred to those less than 65 years old; nearly half of the deaths were of those between 20 and 40.

One possible explanation of this was partial protection of older people exposed to an earlier 1889-1890 pandemic known as the Russian Flu.

Another oddity for the 1918-1919 pandemic was its outbreak in summer and autumn in the Northern Hemisphere; flus are usually worse in the winter.

The 1918-1919 pandemic received its name Spanish Flu for faux-news reasons: World War I censors played down reports of flu deaths in Britain, France, Germany, and the U.S.

However, neutral Spain received no such propagandistic protection and, what’s worse, King Alfonso XIII fell gravely ill from the flu in 1918. A misleading emphasis of the flu’s effect on Spain led to its being dubbed the Spanish Flu.

Where did it start? Researchers have conjectured several scenarios. One identified the first observed case in Haskell County, Kansas, in January 1918, and a first confirmed outbreak at Camp Funston, Fort Riley, Kansas, when a mess cook fell ill on March 11, 1918.

A hospital ward at Camp Funston, Fort Riley, Kansas, 1918.

Other researchers at Britain’s St. Bart’s (where Holmes and Watson met) suggested the pandemic originated at a WWI troop staging and hospital camp in Étampes, in northwestern France. Birds and a pig farm nearby were part of the hypothesis.

A third conjecture, offered in 2014, pinned the rap on China based on serious respiratory illness having broken out there in November 1917. A mobilization of 96,000 Chinese laborers who worked behind British and French lines on the western front brought it to Europe.

However, in 2016, the Journal of the Chinese Medical Association claimed otherwise, with evidence that the virus had been circulating in the European armies for possibly years before the 1918 outbreak.

Whatever the case, it is generally agreed that the problem was exacerbated by overcrowded WWI conditions, reduced resistance of battle-weary (and sometimes gassed) troops, and, with the resulting peace, personnel returning home all over the world.

Autumn of 1918 was the height of the pandemic, as shown in death rates from several of the world’s cities.

A modern flu shot—which, unlike a nasal spray, does not contain a live virus—would have helped too. ds